CMS has published a MLN Matters article on the importance of coding the place of service by physicians and billing agents who submit claims to Medicare.
Publication of the article comes after the OIG conducted an audit to determine whether physicians correctly coded non-facility places of service on selected Part B claims submitted to and paid by Medicare contractors. The OIG found that physicians did not always correctly code nonfacility places of service on Medicare Part B claims. Based on sample results, the OIG estimated that Medicare contractors nationwide overpaid physicians $13.8 million for incorrectly coded services provided during calendar year 2007.
Incorrectly coding the place of service code on claims could result in overpayments that will need to be recovered.
According to the MLM Matters article, CMS is reminding physicians and their billing agents of the importance of correctly coding the place of service and the need for appropriate controls to prevent billing Medicare with incorrect place of service codes.
"It is extremely important that you correctly code the place of service on Part B claims," according to the article. "Using non-facility place-of-service codes for services that are actually performed in hospital outpatient departments or ASCs often results in overpayments. You must insure you have adequate controls in your (or your billing agent's) billing routines to identify potential place-of-service coding errors."
View the MLN Matters article on place-of-service coding (pdf).
Read more about ASC coding:
- CMS Reconsiders National Coverage Determination for MRI
- Connolly Healthcare — RAC for Region C — Posts CMS-Approved Audit Issue for Surgery Center Claims
- Location of Surgery Center List of Payable Medicare Procedures and Ancillary Services